{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T16:42:11Z","timestamp":1792082531444,"version":"4.4.0"},"reference-count":57,"publisher":"MDPI AG","issue":"17","license":[{"start":{"date-parts":[[2023,8,24]],"date-time":"2023-08-24T00:00:00Z","timestamp":1692835200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>While the exact prevalence of disordered eating in youth who are overweight and have obesity has not been determined, studies show that the odds of a young adult (18\u201324 years) with obesity engaging in disordered eating behaviors is 2.45 times more likely to occur than in young adults with Body Mass Indexes (BMI) in the normative range. The purpose of this review is to highlight the role that disordered eating and eating disorders may play in pediatric obesity and the importance of screening for these conditions. The ability to identify and assess disordered eating alters the course of treatment. Without an understanding of the intersection of obesity and disordered eating, medical providers may continue treatment-as-usual. Doing so may inadvertently contribute to internalized weight bias in patients with obesity and exacerbate their disordered eating symptoms and behaviors. In addition, understanding the spectrum of disordered eating in pediatric patients with obesity allows providers to tailor treatments, discuss food and physical activity differently, and know when to refer patients to eating-disorder-specific providers for continued treatment.<\/jats:p>","DOI":"10.3390\/ijerph20176638","type":"journal-article","created":{"date-parts":[[2023,8,24]],"date-time":"2023-08-24T10:47:08Z","timestamp":1692874028000},"page":"6638","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":33,"title":["Disordered Eating and Eating Disorders in Pediatric Obesity: Assessment and Next Steps"],"prefix":"10.3390","volume":"20","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6870-5750","authenticated-orcid":false,"given":"Eileen","family":"Chaves","sequence":"first","affiliation":[{"name":"Department of Pediatrics, The Ohio State University College of Medicine, Columbus, OH 43210, USA"},{"name":"Center of Healthy Weight and Nutrition, Nationwide Children\u2019s Hospital, Columbus, OH 43205, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"D. Thomas","family":"Jeffrey","sequence":"additional","affiliation":[{"name":"Psychology Department, The Ohio State University, Columbus, OH 43210, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dominique R.","family":"Williams","sequence":"additional","affiliation":[{"name":"Abbott Nutrition, Columbus, OH 43219, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,8,24]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"American Psychiatric Association (2022). Diagnostic and Statistical Manual of Mental Disorders, American Psychiatric Association Publishing. [5th ed.].","DOI":"10.1176\/appi.books.9780890425787"},{"key":"ref_2","unstructured":"Deloitte Access Economics (2020). The Social and Economic Cost of Eating Disorders in the United States of America: A Report for the Strategic Training Initiative for the Prevention of Eating Disorders and the Academy for Eating Disorders, Deloitte Access Economics."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"403","DOI":"10.1016\/j.jaac.2015.01.020","article-title":"Weight Status and DSM-5 Diagnoses of Eating Disorders in Adolescents from the Community","volume":"54","author":"Flament","year":"2015","journal-title":"J. Am. Acad. Child Adolesc. Psychiatry"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"665","DOI":"10.1002\/eat.22652","article-title":"Disordered eating in ethnic minority adolescents with oversity","volume":"50","author":"Rodgers","year":"2017","journal-title":"Int. J. Eat. Disord."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"1147","DOI":"10.1002\/eat.23496","article-title":"Risk factors in preadolescent boys and girls for the development of eating pathology in young adulthood","volume":"54","author":"Eeden","year":"2021","journal-title":"Int. J. Eat. Disord."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"8","DOI":"10.1186\/s40337-022-00717-4","article-title":"Risk factors for eating disorders: Findings from a rapid review","volume":"11","author":"Barakat","year":"2023","journal-title":"J. Eat. Disord."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"1337","DOI":"10.1007\/s11606-018-4465-z","article-title":"Prevalence and Correlates of Disordered Eating Behaviors Among Young Adults with Overweight or Obesity","volume":"33","author":"Nagata","year":"2018","journal-title":"J. Gen. Intern. Med."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"e12971","DOI":"10.1111\/obr.12971","article-title":"Treatment of obesity, with a dietary component, and eating disorder risk in children and adolescents: A systematic review with meta-analysis","volume":"21","author":"Jebeile","year":"2019","journal-title":"Obes. Rev."},{"key":"ref_9","doi-asserted-by":"crossref","unstructured":"Stabouli, S., Erdine, S., Suurorg, L., Jankauskien\u0117, A., and Lurbe, E. (2021). Obesity and Eating Disorders in Children and Adolescents: The Bidirectional Link. Nutrients, 13.","DOI":"10.3390\/nu13124321"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"549","DOI":"10.1016\/j.chc.2019.05.003","article-title":"Binge Eating Disorder in Children and Adolescents","volume":"28","author":"Bohon","year":"2019","journal-title":"Child Adolesc. Psychiatr. Clin. N. Am."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"189","DOI":"10.1037\/amp0000592","article-title":"A developmental framework of binge-eating disorder based on pediatric loss of control eating","volume":"75","author":"Schvey","year":"2020","journal-title":"Am. Psychol."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"185","DOI":"10.1016\/j.psychres.2010.04.005","article-title":"Subclinical eating disorders and their comorbidity with mood and anxiety disorders in adolescent girls","volume":"185","author":"Touchette","year":"2011","journal-title":"Psychiatry Res."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"1284","DOI":"10.1097\/00004583-200010000-00016","article-title":"Epidemiology and Natural Course of Eating Disorders in Young Women from Adolescence to Young Adulthood","volume":"39","author":"Lewinsohn","year":"2000","journal-title":"J. Am. Acad. Child Adolesc. Psychiatry"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"1328","DOI":"10.1002\/eat.23519","article-title":"Restrictive eating disorders in higher weight persons: A systematic review of atypical anorexia nervosa prevalence and consecutive admission literature","volume":"54","author":"Harrop","year":"2021","journal-title":"Int. J. Eat. Disord."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"235","DOI":"10.1007\/s13679-018-0316-9","article-title":"Disordered Eating Attitudes and Behaviors in Youth with Overweight and Obesity: Implications for Treatment","volume":"7","author":"Hayes","year":"2018","journal-title":"Curr. Obes. Rep."},{"key":"ref_16","unstructured":"Centers for Disease Control and Prevention (2023, April 20). (17 May 2022). Childhood Obesity Facts. Centers for Disease Control and Prevention, Available online: https:\/\/www.cdc.gov\/obesity\/data\/childhood.html."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"1278","DOI":"10.15585\/mmwr.mm7037a3","article-title":"Longitudinal Trends in Body Mass Index Before and During the COVID-19 Pandemic Among Persons Aged 2\u201319 Years\u2014United States, 2018\u20132020","volume":"70","author":"Lange","year":"2021","journal-title":"MMWR Morb. Mortal Wkly. Rep."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"476","DOI":"10.1097\/MOP.0000000000000911","article-title":"Eating disorders in adolescent boys and young men: An update","volume":"32","author":"Nagata","year":"2020","journal-title":"Curr. Opin. Pediatr."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"262","DOI":"10.1192\/bjp.2021.105","article-title":"Incidence and outcomes of eating disorders during the COVID-19 pandemic","volume":"220","author":"Taquet","year":"2021","journal-title":"Br. J. Psychiatry"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"1403","DOI":"10.1016\/j.pcl.2011.09.014","article-title":"Counseling and Behavior Change in Pediatric Obesity","volume":"58","author":"Wilfley","year":"2011","journal-title":"Pediatr. Clin. N. Am."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"1089","DOI":"10.1016\/j.jand.2022.01.004","article-title":"Patient-Centered Care for Obesity: How Health Care Providers Can Treat Obesity While Actively Addressing Weight Stigma and Eating Disorder Risk","volume":"122","author":"Cardel","year":"2022","journal-title":"J. Acad. Nutr. Diet."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"100010","DOI":"10.1016\/j.obpill.2022.100010","article-title":"Assessment, differential diagnosis, and initial clinical evaluation of the pediatric patient with obesity: An Obesity Medical Association (OMA) clinical practice statement 2022","volume":"1","author":"Cuda","year":"2022","journal-title":"Obes. Pillars"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"e2022060640","DOI":"10.1542\/peds.2022-060640","article-title":"Clinical Practice Guideline for the Evaluation and Treatment of Children and Adolescents with Obesity","volume":"151","author":"Hampl","year":"2023","journal-title":"Pediatrics"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"100031","DOI":"10.1016\/j.obpill.2022.100031","article-title":"Metabolic, behavioral health, and disordered eating comorbidities associated with obesity in pediatric patients: An Obesity Medicine Association (OMA) Clinical Practice Statement 2022","volume":"3","author":"Cuda","year":"2022","journal-title":"Obes. Pillars"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"257","DOI":"10.1007\/s11892-022-01466-z","article-title":"Loss-of-Control Eating and Cardiometabolic Health in Relation to Overweight and Obesity","volume":"22","author":"Shank","year":"2022","journal-title":"Curr. Diabetes Rep."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"e12367","DOI":"10.1111\/cob.12367","article-title":"Diagnostic and treatment challenges of eating disorders after adolescent bariatric surgery: A case report","volume":"10","author":"Williams","year":"2020","journal-title":"Clin. Obes."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"294","DOI":"10.11622\/smedj.2022078","article-title":"Eating disorders in children and adolescents","volume":"63","author":"Tan","year":"2022","journal-title":"Singapore Med. J."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"1154","DOI":"10.1111\/obr.12444","article-title":"Sleep quality and obesity in young subjects: A meta-analysis","volume":"17","author":"Fatima","year":"2016","journal-title":"Obes. Rev."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"521","DOI":"10.1097\/YCO.0000000000000641","article-title":"Review of the burden of eating disorders: Mortality, disability, costs, quality of life, and family burden","volume":"33","author":"Hoek","year":"2020","journal-title":"Curr. Opin. Psychiatry"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"434","DOI":"10.24095\/hpcdp.42.9.02","article-title":"Sleep duration and eating behaviours among adolescents: A scoping review","volume":"42","author":"Doan","year":"2022","journal-title":"Health Promot. Chronic Dis. Prev. Can."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"67","DOI":"10.1016\/j.metabol.2018.04.001","article-title":"Association of sleep disturbances with obesity, insulin resistance and the metabolic syndrome","volume":"84","author":"Koren","year":"2018","journal-title":"Metabolism"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"51","DOI":"10.1024\/1422-4917\/a000269","article-title":"Body Image Disturbance in Children and Adolescents with Eating Disorders. Current evidence and future directions","volume":"42","author":"Legenbauer","year":"2014","journal-title":"Z. Kinder Jugendpsychiatr. Psychother."},{"key":"ref_33","doi-asserted-by":"crossref","unstructured":"Hansson, E., Daukantait\u00e9, D., and Johnsson, P. (2017). Disordered eating and emotion dysregulation among adolescents and their parents. BMC Psychol., 5.","DOI":"10.1186\/s40359-017-0180-5"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"701","DOI":"10.1007\/s40519-016-0328-y","article-title":"Shame proneness and eating disorders: A comparison between clinical and non-clinical samples","volume":"21","author":"Cavalera","year":"2016","journal-title":"Eat. Weight Disord."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"787","DOI":"10.1007\/s40519-019-00689-6","article-title":"Binge eating and social anxiety in treatment-seeking adolescents with eating disorders or severe obesity","volume":"25","author":"Spettigue","year":"2019","journal-title":"Eat. Weight. Disord.\u2014Stud. Anorexia, Bulim. Obes."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"2143","DOI":"10.1002\/eat.23627","article-title":"Depression and eating disorders in early adolescence: A network analysis approach","volume":"54","author":"Kenny","year":"2021","journal-title":"Int. J. Eat. Disord."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"520","DOI":"10.1080\/07448481.2016.1188106","article-title":"Two Distinct Mediated Pathways to Disordered Eating in Response to Weight Stigmatization and Their Application to Prevention Programs","volume":"64","author":"Simone","year":"2016","journal-title":"J. Am. Coll. Health"},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"2998","DOI":"10.4103\/jfmpc.jfmpc_267_21","article-title":"Adolescent eating behaviors in the UAE: Time to intervene","volume":"10","author":"Abouchacra","year":"2021","journal-title":"J. Fam. Med. Prim. Care"},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"412","DOI":"10.1111\/obr.12491","article-title":"Are loss of control while eating and overeating valid constructs? A critical review of the literature","volume":"18","author":"Goldschmidt","year":"2017","journal-title":"Obes. Rev."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"e13173","DOI":"10.1111\/obr.13173","article-title":"Eating disorder risk in adolescents with obesity","volume":"22","author":"Jebeile","year":"2021","journal-title":"Obes. Rev."},{"key":"ref_41","unstructured":"(2023, January 25). Quality of Life. Oxford Learner\u2019s Dictionaries. Available online: https:\/\/www.oxfordlearnersdictionaries.com\/us\/definition\/english\/quality-of-life#:~:text=quality%20of%20life-,noun,particular%20person%20or%20group%20has."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"173","DOI":"10.1046\/j.1467-789x.2001.00032.x","article-title":"Obesity and health-related quality of life","volume":"2","author":"Fontaine","year":"2001","journal-title":"Obes. Rev."},{"key":"ref_43","doi-asserted-by":"crossref","unstructured":"Stephenson, J., Smith, C.M., Kearns, B., Haywood, A., and Bissell, P. (2021). The association between obesity and quality of life: A retrospective analysis of a large-scale population-based cohort study. BMC Public Health, 21.","DOI":"10.1186\/s12889-021-12009-8"},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"552","DOI":"10.1093\/jpepsy\/jsu012","article-title":"Disordered Eating and Health-Related Quality of Life in Overweight and Obese Children","volume":"39","author":"Gowey","year":"2014","journal-title":"J. Pediatr. Psychol."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"257","DOI":"10.1038\/oby.2007.48","article-title":"Disordered Eating Attitudes and Behaviors in Overweight Youth","volume":"16","author":"Goldschmidt","year":"2008","journal-title":"Obesity"},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"9834j95","DOI":"10.1155\/2014\/983495","article-title":"The Weight-Inclusive versus Weight-Normative Approach to Health: Evaluating the Evidence for Prioritizing Well-Being over Weight Loss","volume":"2014","author":"Tylka","year":"2014","journal-title":"J. Obes."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"375","DOI":"10.1080\/10640266.2014.915692","article-title":"Is the Next Generation of Physicians Adequately Prepared to Diagnose and Treat Eating Disorders in Children and Adolescents?","volume":"22","author":"Girz","year":"2014","journal-title":"Eat. Disord."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"45","DOI":"10.1186\/s40337-022-00570-5","article-title":"Challenges in eating disorder diagnosis and management among family physicians and trainees: A qualitative study","volume":"10","author":"Tse","year":"2022","journal-title":"J. Eat. Disord."},{"key":"ref_49","doi-asserted-by":"crossref","unstructured":"Roberts, K.J., and Chaves, E. (2023). Beyond Binge Eating: The Impact of Implicit Biases in Healthcare on Youth with Disordered Eating and Obesity. Nutrients, 15.","DOI":"10.3390\/nu15081861"},{"key":"ref_50","first-page":"27","article-title":"Clinical review: Modified 5 As: Minimal intervention for obesity counseling in primary care","volume":"59","author":"Vallis","year":"2013","journal-title":"Can. Fam. Physician"},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"e2022058204","DOI":"10.1542\/peds.2022-058204","article-title":"Patient and Family Perspectives on Terms for Obesity","volume":"150","author":"Puhl","year":"2022","journal-title":"Pediatrics"},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"e2022059167","DOI":"10.1542\/peds.2022-059167","article-title":"Seek First to Understand","volume":"150","author":"Williams","year":"2022","journal-title":"Pediatrics"},{"key":"ref_53","unstructured":"Rollnick, S., Mason, P., and Butler, C. (1999). Health Behavior Change: A Guide for Practitioners, Churchill Livingstone."},{"key":"ref_54","first-page":"22","article-title":"Eating Disorders in Primary Care: Diagnosis and Management","volume":"103","author":"Klein","year":"2021","journal-title":"Am. Fam. Physician"},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"100048","DOI":"10.1016\/j.obpill.2022.100048","article-title":"Medication-induced weight gain and advanced therapies for the child with overweight and obesity: An Obesity Medicine Association (OMA) Clinical Practice Statement 2022","volume":"4","author":"Cuda","year":"2022","journal-title":"Obes. Pillars"},{"key":"ref_56","unstructured":"(2023, April 15). Eating Disorders: A Guide to Medical Care. Available online: https:\/\/clinicalnutrition.science\/cms\/upload\/dateien\/NutriBib\/4_Nutritional_Therapy\/2021_Chao_Eating_disorders.pdf."},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"165","DOI":"10.1002\/erv.2503","article-title":"The Prevalence of Past 12-Month and Lifetime DSM-IV Eating Disorders by BMI Category in US Men and Women","volume":"25","author":"Duncan","year":"2017","journal-title":"Eur. Eat. Disord. Rev."}],"container-title":["International Journal of Environmental Research and Public Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1660-4601\/20\/17\/6638\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T20:38:10Z","timestamp":1760128690000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1660-4601\/20\/17\/6638"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,8,24]]},"references-count":57,"journal-issue":{"issue":"17","published-online":{"date-parts":[[2023,9]]}},"alternative-id":["ijerph20176638"],"URL":"https:\/\/doi.org\/10.3390\/ijerph20176638","relation":{},"ISSN":["1660-4601"],"issn-type":[{"value":"1660-4601","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,8,24]]}}}